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U of M Study Links EHRs, Providers

November 4, 2014
by Rajiv Leventhal
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Data from electronic health records (EHRs) has long been used to identify trends among patients, but a new study from a University of Michigan professor has found that found that EHRs can also be used to link patient outcomes with individual providers.

The study, led by health economist and University of Michigan School of Nursing associate professor Dr. Olga Yakusheva, to be published in Health Services Research, focused on nurses and used electronic data on 1,203 staff nurses matched with 7,318 adult medical-surgical patients discharged between July 2011 and December 2011 from an urban Magnet-designated, 854-bed teaching hospital.

The findings suggest that the ability to use EHRs for measuring individual performance of providers, whose contributions to patient outcomes are often invisible, like nurses, opens the possibility for development of performance metrics, performance-based rankings, and merit-based salary schemes to improve patient outcomes and reduce costs.

Principal findings were that nurse effects were jointly significant and explained 7.9 percent of variance in patient clinical condition change during hospitalization. Nurse value-added (NVA) was positively associated with having a baccalaureate degree or higher and expertise level. NVA contributed to patient outcomes of shorter length of stay and lower costs.

“Nurses—like all health professionals—differ in their value-added to patient outcomes,” Dr. Yakusheva said, based on the study’s findings. She and her co-authors concluded: “The ability to measure individual nurse relative value-added opens the possibility for development of performance metrics, performance-based rankings, and merit-based salary schemes to improve patient outcomes and reduce costs.”

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